Friday, June 18, 2021

මා ලද ප්‍රසාද ලිපි

කුමන වෘත්තියක වූවද යම් සේවාවක් කැපවීමකින් කරන්නේ නම් එය ජයග්‍රහණයකි. එසේම එම සේවාව ඔබගේ ඉහල නිලධාරීන් පිලිගන්නේ නම් සහ ඊට වටිනාකමක් දෙන්නේ නම් එය ඔබ ලද විශාල ජයග්‍රහණයකි. 1999 සිට 2009 දක්වා මා මගේ සේවාවන් හමුදාවන් වෙත ලබා දුන්නෙමි. 2002 වසරේ සිට 2006 කාලය දක්වා යුද හමුදාවේ සක්‍රිය සේවයට එක් වෙමින් ශ්‍රී ලංකා යුද හමුදාවේ වර්ධනය වෙමින් පැවති සංග්‍රාමික විඩාව සහ සංග්‍රාමික පශ්චාත් ව්‍යසන ක්ලමථ අක්‍රමතාවට (PTSD) ලක්වූ සොල්දාදුවන් දහස් ගනනකට ප්‍රතිකාර ලබා දුන්නෙමි. මේ සේවාවන් නිසා මා වෙත ලැබූ ප්‍රසාද ලිපි කිහිපයක් මෙහි පළ කරමි. 



හිටපු යුද හමුදාධිපති ජෙනරාල් ඩෙනිස් පෙරේරාගෙන් ලද ප්‍රසාද ලිපියක් 


 
ශ්‍රී ලංකා යුද හමුදා වෛද්‍ය බළකායට සිදු කරන ලද සේවය පසසා ශ්‍රී ලංකා යුද හමුදා වෛද්‍ය බළකා අධ්‍යක්‍ෂක ජෙනරාල් වෛද්‍ය සංජීව මුණසිංහ විසින් මා පිලිබඳව තබන ලද සටහනක් 



ශ්‍රී ලංකා යුද හමුදාවේ ප්‍රහාරක බල ඇණි සඳහා මා විසින් දියත් කරන ලද  යුද ආතතිය පිළිබඳව දේශන මාලාවෙන් පසු ජනරාල් උදය පෙරේරා විසින් මවෙත එවන ලද ලිපිය 



 කොලඹ යුද හමුදා රෝහලේ පශ්‍චාත් ව්‍යසන කලමථ අක්‍රමතාවයෙන් පෙලන සොල්දාදුවන්ට මනෝ ප්‍රතිකාර කිරීම පසසා විශේසඥ මනෝ වෛද්‍ය නීල් ප්‍රනාන්දු මහතා විසින් තබන ලද සටහනක් 




 කොලඹ යුද හමුදා රෝහලේ යුද ආතතියට ලක්වූ සොල්දාදුවන්ට මනෝ ප්‍රතිකාර කිරීම පසසා විශේසඥ විකලාංග වෛද්‍ය  බ්‍රිගේඩියර් එස් .ඩී කරුණාරත්න විසින්  තබන ලද සටහනක් 


කොලඹ යුද හමුදා රෝහලේ යුද ආතතියට ලක්වූ සොල්දාදුවන්ට මනෝ ප්‍රතිකාර කිරීම පසසා විශේසඥ කායික වෛද්‍ය බ්‍රිගේඩියර් එ. කේ ආරියරත්න මිය විසින්  තබන ලද සටහනක් 



විශේශ කාර්‍ය බළකාය උදෙසා මවිසින් සිදු කරන ලද යුද ආතතිය පිලිබඳ දේශනයකින් පසු විශේශ කාර්‍ය බළකා අධ්‍යක්‍ෂක නිලල් ලෙව්කේ මහතා විසින් මවෙත එවන ලද ලිපිය 


සංගාමික පශ්චාත් ව්‍යසන ක්ලමථ අක්‍රමතාවය සහ ළමා සොල්දාදුවන් පිලිබඳව හාවර්ඩ් විශ්ව විද්‍යාලයේ කරන ලද දේශනයකින් පසුව මහාචාර්‍ය ජුඩිත් හර්මන් විසින් මවෙත එවන ලද ලිපිය 









The Similarities And Differences Between The Vietnam War And The Eelam War

 


Nations customarily measure the ‘costs of war’ in dollars, lost production, or the number of soldiers killed or wounded.” But, “rarely do military establishments attempt to measure the costs of war in terms of individual suffering –Richard Gabriel

Ruwan M Jayatunge M.D. 

Vietnam War and the Elam War had many similarities and many differences. However, both represent the horrors of war trauma in the 20th Century. Vietnam War was America’s longest war, spanning the twelve-year period from 1963 to 1975. Of the estimated 2.5 million individuals who served in Vietnam, some 58,000 Americans lost their lives. Another 300,000 were wounded. Vietnam War ended with the defeat of the American forces in Vietnam and the Eelam War was won by the Sri Lankan armed forces. The total defeat of the US forces in Vietnam was somewhat controversial and some have suggested, “the responsibility for the ultimate failure of the war lies not with the men who fought, but with those in Congress. (Vietnam War. Retrieved 2009).

Eelam War was Asia’s longest arm conflict, which lasted for nearly 30 years. Unlike the Vietnam War, the Eelam War had historical roots with hundreds of years of ethnic rivalry. According to some historians, it dates back to the King Dutugamunu era with the South Indian invasion in 205 BC. The ethnic tensions became so intensified during the British colonial rule (1815 – 1948) that followed the divide and rule policy. The repercussions started to emerge after the independence in 1948. The tension between the government and Tamil militant groups had been looming since the 1970s and developed up to a major arm conflict.  There are many definitions and elucidations on the Sri Lankan conflict. Some view it as a terrorist problem and others give multifarious explanations. Jonathan Spence of the Yale University gives his views on the Sri Lankan conflict thus.  In the past decade, Sri Lanka has been engulfed by political tragedy as successive governments have failed to settle the grievances of the Tamil minority in a way acceptable to the majority Sinhala population-(Sri Lanka: History and the Roots of Conflict – Jonathan Spence ).

Associate Professor of Political Science at the University of Colombo- Kumari Jayawardhana emphasizes that the history of ethnic conflict in Sri Lanka is the history of the emergence of consciousness among the majority community, the Sinhala, which defined the Sri Lanka society as Sinhala-Buddhist, thus denying its multi-ethnic character. The growth of this consciousness impinged on the minorities in Sri Lanka to the extent that internal resolutions of the problems become impossible. (Ethnic Conflict in Sri Lanka and Regional Security – Kumari Jayawardhana )  The Late Hon. Lakshman Kadirgamar, -Former Minister of Foreign Affairs expressed his views on the Sri Lankan conflict in the following manner.  “…The whole problem here is not between the Tamil people and the Sinhala people or the Muslim people. They still live very much in harmony and don’t forget a very large number of Tamil people live in the Western Province and the Central province and elsewhere, they get on perfectly well with their brothers & sisters of other communities. This is not a people’s problem at all. It’s not a civil war… ( Lakshman Kadirgamar, at the BBC’s “Hardtalk).

 The Eelam war started with the concept of a separate state that was proposed by the Tamil United Liberation Front or the TULF in 1976. However, before 1976 the Tamil militancy was evolving as secret organizations that were formed by the youth in the North. As a result of series of conspiracies, the Jaffna mayor Mr. Alfred Doreappa was assassinated in 1975. The leader of the LTTE, V. Prabhakaran, later proclaimed that he himself killed Mr. Alfred Doreappa.

The LTTE (The Liberation Tigers of Tamil Eelam) or the Tamil Tigers – a separatist militant organization that was founded in 1976 played a key role in the Eelam War. The LTTE  demand 1/3 of the land territory and 2/3 of the seacoast of the island for the country’s Tamil minority of less than 20%. The FBI described the LTTE as the world’s deadliest terrorist group that had an intricate worldwide network.

The Elam War officially started in 1983 with Island wide communal riots. It gave the LTTE manpower and international recognition. In the beginning, India trained and financed the Tamil militant groups. Among the militant groups, the LTTE became more powerful and efficient as a war machine. The LTTE used the most daring war tactics to fight the Sri Lankan armed forces for over three decades. Most of the fighting took place in the North and East But the conflict also penetrated the heart of Sri Lankan society with Tamil Tiger rebels carrying out devastating suicide bombings in Colombo.

When the armed conflict escalated, the LTTE captured a large territory in the North and East of Sri Lanka. By the 2002 cease-fire, the LTTE controlled more than 15,000 sq km of territory and had its own system of taxes, roads, and courts.

A large amount of money had been pumped to maintain the Eelam War. According to some reports, the LTTE had an annual income of over $300 million. The Tamil Diaspora resides in the Western counties financed the Elam War. In addition, the LTTE used extortions, credit card fraud, and drug trafficking to collect money to buy arms. The LTTE had been banned by the U.S, the European Union, and several other countries as a terrorist organization. The U.S. State Department placed the LTTE on its terror list in 1997. In a January 2008 report, the Congressional Research Service said the LTTE continues to raise an estimated $ 200 to $ 300 million per year despite recent declines in overseas financing.

The Elam War continued until 2009 with brief ceasefires and by May 2009 LTTE had been militarily annihilated by the Sri Lankan armed forces. More than 100,000 personnel fought against the separatists and were able to declarer victory in May 2009. The LTTE finally admitted defeat on May 17, 2009, with the rebels’ chief of international relations, Selvarasa Pathmanathan stating on the website that “This battle has reached its bitter end … We have decided to silence our guns. Our only regrets are for the lives lost and that we could not hold out for longer” ( New York Times, May 18, 2009).

Vietnam was a guerrilla war so was the Elam war. The Vietnam conflict wore many faces. It was at once an insurrection by indigenous guerrilla forces and an invasion by the regular army of a neighboring regime. It was a war of snipers and ambushes, booby traps, and pitched battles. The location of the fighting ranged from the densely inhabited rice basket of the Mekong Delta to the remote, jungled mountains of the Central Highlands, It included both platoon-level “pacification” efforts aimed at small bands of Vietcong and corps-level operations targeted against main-force North Vietnamese Army (NVA) regiments and divisions. (US Army in Vietnam by Vincent H. Demma)

There were a few safe areas and the enemy was elusive. In Vietnam, soldiers were exposed to dreadful battle conditions. Likewise, the Sri Lankan soldiers experienced harrowing combat events in the Northern and Eastern parts of Sri Lanka for nearly 30 years. There have been over 25 major operations (1987-2009) conducted against the separatists starting from Operation Liberation in 1987 to the final combat Battle of Puthukkudiyirippu in May 2009. During these operations, a large number of people (combatants/members of the LTTE / civilians) became physically and psychologically wounded.

More than 8.5 million individuals served in the U.S. Armed Forces during the Vietnam era, 1964-1973. Approximately 2.8 million served in Southeast Asia. Of the latter number, almost one million saw active combat or were exposed to hostile, life-threatening situations (President’s Commission on Mental Health, 1978). Approximately 20 years after the end of the Vietnam War 15.2 % of US Vietnam theater veterans continued to suffer from PTSD (Kulka et al.1990). Overall, in the Vietnam War, an estimated 3 million people were killed and over 1 million were wounded.

Prolonged combat environments can create drastic physical and emotional changes in the combatants. Swank and Marchand’s World War II study of US Army combatants on the beaches of Normandy found that after 60 days of continuous combat, 98% of the surviving soldiers had become psychiatric casualties. The average infantryman in the South Pacific during World War II saw about 40 days of combat in four years. The average infantryman in Vietnam saw about 240 days of combat in one year.

In Vietnam DEROS (date of expected return from overseas) was introduced. Every individual serving in Vietnam knew before leaving the United States when he or she was scheduled to return. The tour lasted 12 months for everyone except the Marines who, known for their one-upmanship, did a 13-month tour. DEROS promised the combatant a way out of the war other than a physical or psychological casualty (Kormos, 1978). Nonetheless, in the Eelam War Sri Lankan soldiers served in the operational areas facing constant hostile attacks sometimes over 12 months. On most occasions, they were exposed to prolonged combat without knowing the date of transfer to non-operational areas or release from the active service. A large parentage of combatants served in the operational areas with uncertainty. There was no Vietnam-type DEROS that allowed the official release of combat. The desertion rate obviously became higher than the Vietnam War.

Desertion rates in the US Army peaked at 6.3% or that’s 63 per 1,000 soldiers in World War 2 and during the war, 21,049 soldiers were sentenced for desertion. The desertion rate for the Korean War was 22.5 per 1,000. Approximately 50,000 American servicemen deserted during the Vietnam War. A survey by the University of Peradeniya in 2003 indicates that up to 49, 143 Sri Lankan Army personnel including 623 officers have been listed as deserters, amounting to one-third of the army’s total strength. In 2003 a general amnesty was given to the deserters by the Defense Ministry and 50,000 army deserters were offered the chance of a legal discharge or to rejoin the army assuming they had deserted within the previous three years and had no criminal record (Harrison, Frances 2003, ‘Amnesty for Sri Lanka deserters’, BBC, 4 March)

In the final stages of the Sri Lankan conflict, nearly 2000,000 military personnel (including the Police) were mobilized and many were in active combat. The Sri Lankan Army had deployed ground forces comprising thirteen Divisions with 140,000 troops (120,000 active troops). Following the Sri Lankan conflict over 90,000 people lost their lives. The deaths include 27,639 Tamil fighters (according to the rebel sources) , more than 23,327 Sri Lankan soldiers and police officers, 1,155 Indian soldiers, and tens of thousands of civilians. The last phase of the war resulted in 280,000 internally displaced persons.

The average age of the World War II combatant was 26 years, the average age of the Vietnam veteran was 19. (some experts challenge Paul Hardcastle ‘s “19 years old and 12,000 miles away”  expression) The average age of the soldiers who fought in the Elam war was 18 – 25. Many of the Vietnam combatants came from the underprivileged social layers so as the combatants of the Eelam war. A large number of youth with low education and low-income groups joined the military and their main aims were to build houses or to educate their younger siblings. Most of these young people had never been to the Northern part of Sri Lanka as civilians. For the first time, they went as combat soldiers to fight the enemies.

The National Vietnam Veterans Readjustment Study (NVVRS) was conducted by the U.S. government following a congressional mandate in 1983 to better understand the psychological effect of being in the Vietnam War. Among Vietnam veterans, approximately 15% of men and 9% of women were found to have PTSD at the time of the study. Approximately 30% of men and 27% of women had PTSD at some point in their life following Vietnam. These rates were much higher than those found among non-Vietnam veterans and civilians. The rates are alarming since they indicate that at the time of the study, there were about 479,000 cases of PTSD and 1 million lifetime PTSD cases as a result of the Vietnam War. (Rates of PTSD in Veterans Matthew Tull, Ph.D.).

The Elam war has produced acute and chronic mental health problems due to war trauma. Although there are no extensive, research done to elicit the PTSD rate in the Sri Lankan armed forces based on the rough estimations the PTSD rate could be 8 – 12% (Combat-Related PTSD among the Sri Lankan Combatants – Neil Fernando / Ruwan M Jauaunge)

During the Vietnam War and in the post-Vietnam era US soldiers had effective psychological support services. Many PTSD research works were initiated after the Vietnam War. Psychiatric evacuations were done effectively when compared to the Eelam War. Unfortunately, psychological support services were not systematically catered to soldiers who fought in the Eelam War. Sri Lankan armed forces had no fully qualified military psychologists throughout the war and most of the psychological ailments were not methodically treated. There were no psychological first aid services at the war front and much attention was paid to the physical wounds. For long years, PTSD was considered an American illness that had nothing to do with the Sri Lankan combatants. These myths have created a large number of psychological casualties. Still, the true numbers are unknown.

The American public did not directly experience the war impact since it was fought 12,000 miles away. The US public experienced the repercussions of war trauma at its end. But the impact of the Eelam war affected the Sri Lankan civilian population since its beginning. During these long years of armed conflict in Sri Lanka, civilian communities in the North and the South experienced a collective trauma. There was no safe ground for the civilians in the South due to suicide bombings conducted by the LTTE. The LTTE is responsible for 109 major suicide bombings in which thousands of people died. From 1975 to – 2008, the Liberation Tigers of Tamil Eelam assassinated nearly 47 democratically elected politicians.

Both Vietnam and the Eelam wars represented human tragedies. Although the phenomenon of child soldiers was never a part of the Vietnam War, in the Eelam War it became a heartrending reality. (Following the Vietnam War  when the conflict spread to neighboring Cambodia Pol Pot recruited a large number of children to his Khmer Rouge movement) The LTTE recruited child soldiers despite the international protests. According to a 1996 U.N. report, children as young as 10 were used to kill women and children in remote rural villages, in combat in the 1990s, between 40% and 60% of the dead Tiger fighters in Sri Lanka were children under the age of 18. (2004 Human Rights Watch report)

Demographically, Vietnam veterans comprise only a small minority of America’s largest, most influential generation (Baskir and Strauss, 1978). In this context, the Sri Lankan combatants too play a major role in society. Many ex-Army officers are in the field of politics and in the public service. Even the former commander of the Sri Lanka Army contested in the 2010 Presidential elections.

Unlike the WW 2 veterans, the Vietnam combatants entered the homeland not as heroic victors, but as embarrassed and tired veterans. Although the Sri Lankan veterans were hailed by society as heroes in the final days of the war, most of the traumatized Sri Lankan veterans are not receiving appropriate rehabilitation and psychosocial support services. This would lead to generating a large number of stress factors among the combatants. In addition, rehabilitation and social integration of ex-militants are essential to break down the vicious cycle of war. The Sri Lankan society needs resolution, reconciliation, and peace-building activities to harmonize the country that was tormented by a prolonged armed conflict.

A number of studies point out that Vietnam veterans subjected to more extensive combat show symptoms that are more problematic during the period of readjustment (Wilson, 1978; Strayer & Ellenhorn, 1975; Kormos, 1978; Shatan, 1978; Figley, 1978b). In the same way, a considerable number of ex-servicemen from the Sri Lanka Military might undergo war-related readjustment problems and this problem would escalate in the future.

The material costs of both wars were immense. A Cornell University study placed the overall total U.S. cost of the Vietnam War at $200 Billion. The cost of the Eelam War was 23 trillion Rupees (According to the statement made by the Deputy Finance Minister Ranjith Siyambalapitiya in 2010 ) 1 USD = 130.2708 LKR  (The US Dollar Sri Lankan Rupee exchange rate as of November 2012)

The Vietnam War divided the US general public. Some openly criticized the war effort in South East Asia. High-profile opposition to the Vietnam War turned to street protests in an effort to turn U.S. political opinion against the war. Prominent celebrities like Bob Dylan, John Lennon, Jane Fonda, Muhammad Ali, etc openly denounced the Vietnam War. The public outcry was strong and many civil liberty movements seeking social justice backed it. The racial tension became intense and the Vietnam War was overtly called the white man’s war. (86% of the men who died in Vietnam were Caucasians, 12.5% were African American, 1.2% were other races. -CACF and Westmoreland papers).

Although some NGOs conducted protests against the Eelam War, it did not make a huge impact on the public. People believed most of the NGOs that were funded by foreign sources were a threat to Sri Lanka’s sovereignty, as well as to national security. Most of the protests that were carried out against the war were biased and showed a one-sided picture. Such protests condemned the attacks carried out by the Government forces but did not highlight the atrocities committed by the LTTE. Some antiwar protests were funded by the pro-LTTE organizations and people have lost faith in numerous anti-war demonstrations.

Many people questioned the hidden motives of such NGO s and their true agenda. Therefore, people became silent observers. Only a very few spoke for the sake of humanity underlining the dark side of the war and the human tragedy beneath it. But they were called traitors by the ultra-nationalists and their voices were unheard. There was no effective public protest against the war in the South or in the North during the 30-year war in Sri Lanka.

With the end of direct American troop involvement in Vietnam in 1973, the number of veterans, presenting neuropsychiatric disorders began to increase tremendously (President’s Commission on Mental Health 1978). The Vietnam War teaches many lessons. The Korean War had produced a lesser amount of psychological casualties when compared to the Vietnam War due to the work of Dr. Albert Glass who pioneered the psychological mode of management of the war-affected combatants. Unfortunately, his recommendations were not taken into considerations during the Vietnam War and the Veterans and the American society paid an immense price. Sri Lankan society will defiantly face the challenges of combat stress and the Islanders have already started experiencing some bitter lessons in the post-war era.

The psychological damage caused by the Eelam War is greater than the Vietnam War. As Daya Somasundaram Clinical Associate Professor in the Psychiatry University of Adelaide, points out the long-running armed conflict in Sri Lanka caused more mental health problems and social breakdown than the catastrophic 2004 tsunami.

Due to two decades of armed conflict in Sri Lanka, victims of terror have been profoundly affected psychologically and socially. The impact is seen at the individual, family, and community levels. Epidemiological surveys show that civilians have experienced widespread traumatization, with high levels of somatization, anxiety, depression, Posttraumatic Stress Disorder (PTSD), relationship problems, and alcohol abuse. At the community level, the cumulative effect of terror is collective trauma, with a general tendency to mistrust, dependence, silence, withdrawal, passivity, and lack of motivation. Socially, there is evidence of deterioration in values and ethics with marked increases in child abuse, violence against women, crime, and brutalization. (Short- and Long-Term Effects on the Victims of Terror in Sri Lanka- Daya Somasundaram )

The repercussions of combat trauma will definitely affect Sri Lankan society as the Vietnam syndrome affected American society. The Vietnam War was an imported war to America. It never occurred on American soil. But the Elam war took place on Sri Lankan soil and psychological devastation is larger than the Vietnam War. The health authorities, government policymakers, the political hierarchy must realize this impending danger and must take preventive measures to minimize the psychosocial damage of the Eelam War.







Tuesday, June 15, 2021

කමාන්ඩෝ සෙබළුන්ට ප්‍රතිකාර කිරීම

 

යුද හමුදා රෝහලේ සේවය කරන කාලයේදී කමාන්ඩෝ රෙජිමේන්තුවේ සෙබළුන් සහ නිලධාරීන් කිහිප දෙනෙකු ප්‍රතිකාර සඳහා මා වෙත යොමු කල බව කිව යුතුය​. කමාන්ඩෝ රෙජිමේන්තුවේ එක් නිලධාරියෙකුට මම වසර ගනනාවක් ප්‍රතිකාර කලෙමි. ඔහු පැරෂූට් පිම්මකදී වැරදීමක් සිදු වීමෙන් බිම වැටී ඔහුගේ මොලය තුවාල (TBI - Trumatic Brain Injury)  වී තිබුණි. ඔහු තුල විශාදය මෙන්ම පෞරුෂත්ව වෙනස්වීම් ද සිදු වෙමින් තිබූ අතර මා ඔහු සඳහා මූලික වශයෙන්  ප්‍රජානන ප්‍රතිකාර (Cognitive Therapy ) යොදා ගත්තෙමි. මෙම ප්‍රජානන ප්‍රතිකාර සඳහා මට මාර්ගෝපදේශනය ලැබුනේ වෛද්‍ය ඇලෙක්සැන්ඩර් ලුරියා ගේ සායනික ප්‍රතිකාර පිලිබන විස්තර කියවීමෙනි. වෛද්‍ය ඇලෙක්සැන්ඩර් ලුරියා යනු දෙවන ලෝක මහ යුද්දයේදී මොලය තුවාල වී තිබූ සොල්දාදුවන් සඳහා ප්‍රතිකාර කල ප්‍රකට වෛද්‍යවරයෙකි. මෙම නිලධාරියාගේ සායනික ප්‍රගතිය සෙමෙන් වූවද ඔහු වසර 2-3 ඇතුලතදී යම් සාර්ථකත්වයක් ලබා ගත්තේය​.


විශේසඥ වෛද්‍ය කර්නල් එම් මුතුමාල මහතා විසින් මවෙත යොමු කරන ලද තවත් කමාන්ඩෝ රෙජිමේන්තුවේ නිලධාරියෙකු  යුද ආතතියට නිරාවරණය වීම නිසා නිතරම තද හිසරදයෙන් පෙළුනේය​. ඔහු කමාන්ඩෝ රෙජිමේන්තුවේ ස්වේච්ඡා බළකායේ නිලධාරියෙකු විය​. මෙම නිලධාරියා සඳහා EMDR මනෝ ප්‍රතිකාරය ලබා දුන් අතර එමගින් ඔහුගේ තත්වය යහපත් විය​.

වරක් කමාන්ඩෝ භටයෙකු මරාගෙන මැරෙන ත්‍රස්තවාදියෙකු ආසන්නයට යාමේදී ත්‍රස්තවාදියා විසින් බෝම්බය පුපුරුවා ගන්නා ලදි. එම පිපිරීම නිසා කිසිදු ශාරීරිකව තුවාලයක් නොවූවද අදාල සෙබලා තුල මනෝ කායික රෝග ලක්‍ෂණ ( Somatoform Disorder) පහල විය​. ඔහු නිතරම තදබල පිට කොන්දේ වේදනාවකින් පෙළුනේය​. ඔහුව පරික්‍ෂා කරන ලද විශේසඥ ශල්‍ය වෛද්‍ය එස් එස් ජයරත්න මහතා මෙම පිට කොන්දේ වේදනාව සඳහා කායික හේතූන් නොවූයෙන් මනෝ ප්‍රතිකාර සඳහා මවෙත යොමු කරන ලදි. මෙම  කමාන්ඩෝ සෙබලා උදෙසා අප වේදනාව ප්‍රතිග්‍රහ කර ගනිමින් භාවනා කිරීමට යොමු කරන ලදි. යම් ආකාරයක් වේදානුපස්සනා භාවනාවක් වන මෙම ක්‍රමය වර්තමානයේ වැඩි දියුණු කරන ලද්දේ මැසචූසෙස්ට්ස් විශ්ව විද්‍යාලයේ මහාචාර්‍ය ඇමී වොච් හෝල්ට්ස් විසිනි. පසුව මා මහාචාර්‍ය ඇමී වොච් හෝල්ට්ස් සමග " Treating Chronic Pain With Meditation' යන මාතෘකාවෙන් පරියේෂණ ලිපියක්ද එළි දැක්වූයෙමි. 

මනෝ වෛද්‍ය නීල් ප්‍රනාන්දු මහතා විසින් මනෝ ප්‍රතිකාර සඳහා මා වෙත යොමු කරන ලද එක් ජේෂ්ඨ කමාන්ඩෝ සෙබලෙකු යුද ආතතිය නිසා ග්‍රස්තීය අක්‍රමතාවකට (Obsessive Compulsive Disoder) ලක්වී සිටියේය​. බොහෝ ක්‍රියාන්විත වලට සහභාගි වී තිබූ ඔහු තොප්පිගල ප්‍රදේශයේ ක්‍රියාන්විතයකදී තුවාල ලැබීය​. ඉන් පසු ඔහු තුල ග්‍රස්තීය අක්‍රමතාව ක්‍රමක් ක්‍රමයෙන් වර්ධනය විය​. මෙම සෙබලාට වසරකට ආසන්න කාලයක් මා ප්‍රතිකාර කලෙමි. ඔහු සඳහා ප්‍රති විශාද ඖෂධ මෙන්ම ප්‍රජානන ප්‍රතිකාර සහ චර්‍යාත්මක ප්‍රතිකාර (Behaviour Therapy ) යොදා ගන්නා ලදින් ඔහු ඉතා සැලකිය යුතු සායනික ප්‍රගතියක් ලැබුවේය.

වෛද්‍ය රුවන් එම් ජයතුංග 

Sunday, June 13, 2021

සන්නස්ගල සහ ඝාතකයෝ

ග්‍රාමීය පසුගාමීත්වයෙන් දරිද්‍රතාවයෙන් පීඩා විඳ , පීඩිත පන්තියේ සිට ඉහල පන්තියකට පැන ගැනීමේ වියරු ආශාව සමග , සමාජ තත්වයක් ලබා ගැනීමට අසිහියෙන් දතකෑම​, සුඛෝපභෝගී භාන්ඩ අත් පත් කර ගැනීමට දක්වන ගිජුකම යන විපරීතයන් ඉහට ගැසූ වෛද්‍ය සිසුවෙකු පසුකාලීනව දොස්තර කෙනෙකු වූ පසු ඔහුගෙන් ප්‍රතිකාර ලබා ගැනීමට එන රෝගීන්ට  ඔහු කෙසේ නම් සලකයිද ? මේ සත්‍ය කතාවට සවන් දෙන්න.

 කතාව පවසන්නේ උපුල් ශාන්ත සන්නස්ගල ය  

කොළඹ කතාව - දොස්තර පරිච්ඡේදය ; 

Link;https://www.youtube.com/watch?v=BXol6526NIA




Thursday, June 10, 2021

Maxim Gorky: The man who believed in social justice

 

When work is a pleasure, life is a joy! When work is a duty, life is slavery’ -Maxim Gorky

Maxim Gorky was a self-learned author, who had the undying curiosity to explore society and discover its hidden realities. His writings remarkably showed Gorky’s interest in social reform. He had an outstanding ability in the literature despite the interrupted education that he received. Gorky learnt from society. It was his University the institution of higher education where he gathered immense knowledge.

Orphaned at the age of 11, Gorky experienced the hardships of life. He did a number of odd jobs and while working he developed his reading skills. His grandmother Akulina was the most influential person in his life. Gorky later described her as the most loving and caring human being that he had met in his lifetime.

Gorky widely travelled in Russia. He became acquainted with the lowest members of society. He elegantly wrote about people describing their appearance, character and behaviour. His literary characters were based mostly on outcasts Gorky had met during his travels. Among these characters Smuri - a kind sailor, Matriona - a wicked old woman, Natalia Kazlova - a Prostitute, Nikiparich - a Police spy, Gogaleve – an Alcoholic, Guri Plethnikove - a young Revolutionary were incomparable and they made a profound impact on his Autobiography.


He analyzed all these characters without judging or criticizing them. Gorky was a Great Russian writer who emerged from the common people. He wrote a complex moral perspective on Pre Revolutionary Russia. He regarded literature as an essential food for the human spirit. The aim of literature as Gorky argued is to help man to understand himself, to strengthen the trust in himself, and to develop in him the striving toward truth; it is to fight meanness in people, to learn how to find the good in them, to awake in their souls shame, anger, courage; to do all in order that man should become nobly strong.

Gorky supported the Revolutionary movement in Russia, but he relinquished the moral right for revolutionaries to use violence. Even though the life has been built on cruelty and force in Tsar’s Russia he never believed a revolution or a social change, which needed human blood as fuel. Once he stated “I am capable of leading the masses, and not a weapon in the hands of shameless adventurers of fanatics gone mad.”

In 1906 Gorky wrote his most influential novel Mother narrating the life of a young revolutionary Pavel Vlasov and his mother Pelagea Nilovna. After writing this novel, he was hailed as a Revolutionary writer. Maxim Gorky was called the founder of the doctrine of socialist realism. Gorky supported for the overthrow of the Russian Autocracy. He openly protested against the persecution of the Jewish community in Russia.

He openly supported the Bolshevik movement and became a close friend of Lenin. He strongly opposed the World War 1 and had to face the heavy criticism by the Nationalists for being unpatriotic. But Gorky believed in human freedom and human will to thrive and stood by his principles.

When Maxim Gorky realized that the terror would follow after the October Revolution he was disappointed. When Stalin wrote “The Revolution neither pities nor buries its dead.” Gorky said that the Bolshevik leaders have been poisoned by the rotten venom of power.

All his life Maxim Gorky stood for the freedom of speech and of person and banished the Totalitarian ideology. Stalin once wanted Gorky to write a biography of him. But the great writer declined that offer even endangering his life. Stalin’s growing suspicion was projecting towards Gorky as well. He was kept under close surveillance by Stalin’s Secret Police. Gorky donated most of his income to the revolutionary movement and he had high anticipations. He believed and widely wrote about the social movement in Russia. But when the social movement which he believed became another instrument of terror he was utterly disappointed.

Struck by personal as well as social tragedies Gorky’s health deteriorated rapidly and he died on the 18th June 1936. Some believe that Maxim Gorky was poisoned to death on orders by Stalin.

Gorky’s work had an eternal passion for justice. It stimulated the revolutionary feelings in Russia. His protagonists were not Kings or Queens. They were ordinary people who experienced difficulties in day-to-day lives. He had a great sympathy for mankind. He described the human feelings in a wonderful romantic text. In the same time, he wrote about hunger, social prejudices and inequality that were strongly connected with the Human Society.

Ruwan M Jayatunge M.D. 

Thursday, June 3, 2021

The Eyewitness of Hotel Rwanda




From a tiny window of   hotel Rwanda
I saw two tribes killing each other
Man against man
Brother against brother
I witnessed killings and massacre

The insane evil Radio
Controlled the minds of people
Constantly giving commands
Go go go
Go and kill cockroaches

The good men of yesterday
Turned into savages
No remorse or guilt
Seeking blood and human flesh

I saw little orphans in fear of death
Looking for safe places
No place to run
No place to hide  
They were abandoned by the rest of the world

Ruwan M Jayatunge 

Monday, May 31, 2021

The Kamloops residential school represents the very dark history of Canada



The Remains Of 215 Indigenous Children Have Been Found At A Former School In Canada

The remains of 215 children, including some as young as three, have been found in a mass grave on the grounds of a former residential school that was once part of a nationwide effort in Canada to separate Indigenous children from their families in an attempt to assimilate them.
From the 19th century until the 1970s, more than 150,000 First Nations children were required to attend state-funded Christian schools as part of a program to assimilate them into Canadian society. They were forced to convert to Christianity and not allowed to speak their native languages. Many were beaten and verbally abused, and up to 6,000 are said to have died.
Justin Trudeau stated ;
The news that remains were found at the former Kamloops residential school breaks my heart - it is a painful reminder of that dark and shameful chapter of our country’s history. I am thinking about everyone affected by this distressing news. We are here for you

Friday, May 28, 2021

Combat Trauma And Post War Sri Lanka

   


Ruwan M Jayatunge M.D. 

The Sri Lankan society experienced a 30-year prolonged armed conflict that changed the psychological landscape of the Islanders. A large number of combatants, civilians, and members of the LTTE underwent the detrimental repercussions of combat trauma. Following the armed conflict in Sri Lanka over 90,000 people lost their lives and thousands of families are still grieving. A large number became physical and psychological casualties of the war.  The war trauma still echoes in Sri Lankan society.

War has serious consequences for both short-term survival and longer-term recovery and development (Sørensen, 1998). War trauma represents a horrendous experience for the Sri Lankans. The Sri Lankan society is still struggling with the negative aftermath of the 30-year armed conflict.  If not addressed effectively the psychological scars following combat can stay behind for many years. It can change the psychological markup of people making them more dysfunctional. 

Londoño and colleagues (2012) indicate that exposure to violence in general and to armed conflict, in particular, has been consistently associated with an increased prevalence of mental illness.  Although mental disorders are a major public health problem, the development of mental health services has been a low priority everywhere, particularly in low- and middle-income countries (Minas, 2012).

 War trauma has impacted Sri Lankan society at every level. The social fabric has been severely damaged. It has become a part of social experience and memory.  As the Salvadorian psychologist Martin-Baro wrote of his own country, what was left traumatized were not just Salvadorian individuals, but Salvadorian society. This expression is totally applicable to Sri Lanka.

During the post-war period interpersonal violence, child abuse, rape, alcohol and drug abuse, social violence have been increased in significant numbers. Many of these social maladies have direct or indirect connections with war trauma.  Deplorably Psychological wounds of the Eelam war were not adequately addressed and the deleterious effect of combat trauma impacts the post-war Sri Lankan society.

Nature of the Sri Lankan Conflict

The Sri Lankan Conflict was the longest-running armed conflict in Asia.  It was a conflict between the Government Forces and a rebel separatist group better known as the LTTE (The Liberation Tigers of Tamil Eelam).  The LTTE was regarded as the most lethal terrorist group in the world. In the subsequent years, the LTTE was banned in the UK, the US, and Canada. The LTTE   attacked the Sri Lankan armed forces with modern high-tech weapons. In addition, the LTTE used numerous unconventional methods to fight the Sri Lankan Forces using child soldiers and suicide bombers. The Northern conflict consumed many lives and caused damage to the property worth billions of dollars.

Sri Lankan Combatants and War Trauma

Sri Lankan military forces deployed their entire bayonet strength for nearly 30 years.  During this critical period, the Sri Lankan military launched nearly 20 major military operations against the LTTE. Over 200,000 members of the Sri Lanka armed forces and Police had been directly or indirectly exposed to combat events during these years.  They were exposed to hostile battle conditions and many soldiers underwent traumatic battle events outside the range of usual human experience. In 2009 May the Sri Lankan government declared that the country won the war against the LTTE. Although the armed forces were able to gain a decisive victory it came with a huge social cost. The Eelam war affected the psychosocial health of the combatants. Significant numbers are still impacted by combat trauma. During the post-war era, high numbers of desertions and suicides have been reported among the combatants.  According to the Military Spokesperson of the Sri Lanka Army from 2009 to 2012 postwar period nearly 400 soldiers had committed suicide (Sriyananda, 2012).

The Social Impact of Combat-Related PTSD

The experts believe that the circumstance of war can produce a range of emotional, psychological, and behavioral stress reactions among soldiers and officers that can lead to a condition known as PTSD (Post Traumatic Stress Disorder). Posttraumatic stress disorder (PTSD) is a condition that engenders both symptomatic distress and severe disruption in interpersonal and social functioning (robertson et al. 2004).

During the Eelam War, many soldiers experienced combat-related psychologically distressing traumatic reactions. Most of these acute traumatic reactions were not appropriately diagnosed or treated. Some soldiers were emotionally overwhelmed as a result of war trauma. There was no apparatus to identify these distressing reactions and offer psychological first aid without delay. Some soldiers lived with the traumatic ruminations for years while serving in the operational areas. These victims were later diagnosed with combat-related PTSD.

For a number of years, the Sri Lankan authorities were reluctant to believe that combat-related PTSD   was emerging in the military. PTSD was regarded as an American illness and there was an unofficial taboo to use the term PTSD. The tension of combat trauma was mounting in the military over the years and there had been suicides and self-harms reported from the battlefields. The soldiers affected by war trauma had behavioral problems and their productivity was plummeting. Many soldiers who had positive features of combat-related PTSD without any physical wounds were compelled to serve in the operational areas and engage in active combat. In the early days of the war, soldiers were sometimes charged with malingering when they tried to seek medical attention. Many traumatized veterans deserted the army or joined underworld criminal gangs. Until 2005 the Sri Lanka Army did not medically discharge any combatant on psychological grounds especially PTSD.

The laborious work of Dr. Neil J Fernando- the former Consultant Psychiatrist of the Sri Lanka Army gave an insight to the authorities to think about war trauma and PTSD seriously. The first soldier who was able to get a medical discharge with PTSD (in 2005) was a Lance Corporal with malignant PTSD. He was a POW who was held by the LTTE for nearly 5 years.

Combat-related PTSD has impacted combatants hugely.  The wounds that they received from the war were not confined to the battlefield. It was not an individual trauma anymore.  The war trauma frequently transformed their domestic environments. Domestic and community violence, child abuse addiction issues, self-harm, etc. became massive social problems. War trauma has turned into a vicious cycle affecting individuals as well as the entire society.

The Residual Effect of Combat Trauma

It is important to know that in the post-war era late reactions of combat-related PTSD can emerge. Combat stress has a residual effect on some veterans. For some soldiers combat related traumatic reactions can emerge at a later date. Posttraumatic stress disorder (PTSD) may develop as a serious long-term consequence of traumatic experiences, even many years after trauma exposure (Lecic-Tosevski et al. 2013). There is a risk of emergence of late reactions of combat-related PTSD in the post-war Sri Lankan society.

According to Dr. Michael Robertson of the Mayo Wesley clinic, ex-servicemen can experience delayed reactions to combat stress. A large number of WW2 Veterans who never had any anxiety-related symptoms later complained of Delayed PTSD. Some reactions were manifested 40-50 years after the original trauma. Therefore the health authorities in Sri Lanka should be aware of the late reactions of combat-related PTSD.  Studies are needed to systematically assess the mental health of the members of armed services who fought a prolonged war.

Combat Trauma among the ex LTTE Carders

Combat Trauma among the ex LTTE Carders is least discussed. Very few studies are available on the mental health factors relating to ex-militants. Many surviving members of the former LTTE either now live in Sri Lanka or live abroad. Most of these ex-militants joined the movement as children and throughout the war, they underwent the harsh realities of war trauma.

As children, these members witnessed and engaged in violence. While spending time on the battlefield they turned into adults. As adults, they continuously lived through battle stress until the end of the conflict in 2009.

Mental health experts believe that psychological trauma experienced by people during their childhood has a higher tendency to manifest mental health problems in later life.   According to several mental health experts, some of the ex LTTE members suffer from malignant PTSD (Disorders of Extreme Stress Not Otherwise Specified or DESNOS). These victims live with rage, guilt, alienation and suicidal ideation. They lack social skills and unable to form families due to a lack of parental skills and intimacy. Although a number of rehabilitation projects were launched by the Sri Lankan government to rehabilitate the former militants some of them still live with scarred minds. Those who managed to flee and live as refugees in the Western countries do not receive culturally fitting psychological rehabilitation therapy. These individuals need psychosocial rehabilitation in order to reintegrate into society.

The Child soldiers in the Sri Lankan Conflict 

Over 7000 children were forcibly recruited and sent to war by the LTTE during 1983 – 2009 (Human Rights Watch). Children were abducted and forced into weapon training and they were subjected to torture, indoctrination, sleep deprivation, and often forced to commit atrocities.   During the Eelam War, these children witnessed absolute carnage that would impact their future adult lives.

Former child soldiers have numerous mental health issues. Children who survive traumatic events exhibit a diverse set of symptoms and physical signs often meet with diagnostic criteria for attention-deficit hyperactivity disorder, anxiety disorder, etc (Perry, 2003).

In 2009 the Sri Lankan Government liberated all the child soldiers that were held by the Tamil Tigers. These child soldiers were reunited with their families and they were offered rehabilitation.  Among the conflict-ridden countries, Sri Lanka became the first state to free all the child soldiers that were held by the rebel group.  Today Sri Lanka is free of child soldier menace.  This is a major victory to the civilized world that sternly condemns the military use of children.

Today these ex-child soldiers undergo rehabilitation. Most of them go to schools and receive vocational training.  But still many are trapped with their dreaded combat memories. According to the local clinicians, a considerable number of Sri Lankan child soldiers are suffering from depression, PTSD, somatization, and adjustment disorders. They need effective long-term rehabilitation and acceptance by society.

The Civilians Affected by the War   

In armed conflicts, civilians have little protection from collateral or incidental damage and often they become vulnerable. Among the consequences of war, the impact on the mental health of the civilian population is one of the most significant (Srinivasa Murthi & Laksminarayana , 2006). The recent military conflicts in Afghanistan and Iraq had a large number of civilian casualties.  The Eelam War in Sri Lanka was no exception. A large number of civilians from the North and South became innocent victims of the war in Sri Lanka. Many became casualties due to the colorectal damage following military offensives against the rebels (in the North) and suicide bombing by the LTTE (in the South).

According to the International Institute for Strategic Studies (2003) between 1980 and 2000, the LTTE carried out 168 suicide attacks causing heavy damage to civilian, economic, and military targets. Suicide bombings and other forms of explosions can cause long-term repercussions on survivors. Bashir and colleagues (2013) highlight that civilian victims of suicidal and improvised bombings present with a wide range of neurological symptoms and injury patterns, which often differ from the neurological injuries incurred by military personnel in similar situations, and thereby often require individualized care.

The Sri Lankan conflict caused mass displacements. At the end of 2006, at least 520,000 people in Sri Lanka were victims of conflict-induced displacement in a country of 20 million, making up one of the largest displacement crises in Asia in absolute terms and particularly in terms of the proportion of the population displaced (Civilians in the way of conflict: Displaced people in Sri Lanka September 2007).  Many civilians who became displaced lived in shelters for long years and fled the country. Adverse mental health consequences have been reported among the displaced people.

The war trauma in Sri Lanka destroyed the social fabric and a large number of civilians underwent hardships of war. People lost their loved ones. They lost their property and livelihoods.  It affected the individual as well as on a collective level.  For most of the Sri Lankans, the war became a collective trauma. Tens of thousands of Sri Lankans still face the bitter consequences of the war. They live with their traumas suffering silently.

Civil society has been degraded by war trauma. Hostility, suspicion, alienation, emotional numbing, indifference, scapegoating became the common components in the war-ridden Sri Lankan society. Empathy, tolerance, and compassion gradually disappeared as the war progressed. There is a noticeable lack of quality in civil society, partly due to the crippling brain drain, but also due to the devastating effect of the war. There is also a widely reported perception in northern Sri Lanka that there has been a marked deterioration in social values evidenced by changing sexual and social behaviors. (Somasundaram 2007)

The researches indicate that armed conflict can have long-term consequences. Nandi (2013) investigated to what extent the soldiers and young women of World War II were affected by PTSD symptoms over the course of their lives and in this study, the researchers recruited 52 male and 20 female Germans aged 81-95 years and interviewed regarding war experiences and PTSD symptoms. Of the men, 2 % and 7 % met the criteria for current and lifetime PTSD diagnoses, respectively, as compared to 10 % and 30 % of the women, respectively. These researches show that the impact of war trauma can affect Sri Lankan society for long years.

 

The Eelam War and the War Widows

One harsh reality of the war is that every soldier killed in war leaves behind grieving family and relatives. It has been a reality since the Trojan War. The women who have left widows as a result of the Sri Lankan conflict are facing radically altered circumstances. There are estimated thousands of war widows who still experience grief reactions. Many widows young and with the death of their husbands these women have become a psychologically and socially vulnerable group. Most of the women who underwent severe emotional pain still have not completely recovered. Many have become the victims of pathological grief and were clinically diagnosed with Prolonged Grief Disorder or PGD.

They are unable to work through their grief despite the passage of time. With widowhood, they experience identity change, role adjustment, and change in social status.

Many researchers concur that the mental trauma of the war widows can last for long years. Depressive reactions are common among the Sri Lanka war widows. Many LTTE carders who died in action left their wives in grief-stricken situations. The war widows of the Northern part of Sri Lanka experienced a similar plight.

In conservative Asian societies, widows face social, economic, and legal handicaps. Widow as its name denotes is associated with some form of socio-cultural stigma and humiliation. They are considered a bad omen in many Sri Lankan rural areas. They are marginalized by their own communities. These factors affect their self-esteem. In some events, the accusations were made by the in-laws stating that the husband’s death occurred because of the unluckiness of the wife and they are partially answerable for the husband’s death. They experience a lack of social support and loss of their social possession in their own family circles.

The war widows face a number of mental health problems. They have suffered bereavement as a result of the violent deaths of their husbands and these traumatic memories hound them for long years. They are often subjected to extreme forms of discrimination and physical, sexual, and mental abuse. Therefore, widowhood represents a form of “social death” for these women.

Healing the Post War Sri Lankan Society

Post-war societies are highly vulnerable. Therefore the combat trauma in the post-war era has to be managed effectively. There are numerous examples from other countries that reveal the susceptibility of the social networks and communities in the post-war period.  For example, soon after the American Civil War, some of the traumatized soldiers formed an extremist movement called KKK which engaged in racial violence. Many American volunteers who participated in the Spanish Civil War engaged in social violence and some Lincoln Brigade soldiers became top criminals. Post-Vietnam War caused vast social chaos in the USA. Similarly, many Afghanistan veterans of the Red Army engaged in organized crimes in the former USSR.

Soon after a mass conflict like war, there is a tendency to political extremism and sometimes religious fundamentalism to emerge. In a post-conflict, society the social fabric is fragile, people are traumatized and they become easy targets to these extreme and damaging forces. Soon after WW 1, Germany faced such a situation, and NAZIS could exploit the collective trauma experienced by the German people. The Taliban fundamentalists grabbed power at the end of the Afghan-Soviet conflict. Hence, there is an impending risk that Sri Lankans face today and the Democratic forces have an absolute responsibility to restore the peace and justice system in the Country

The major impacts of war include the disintegration of communities and damaging the psychological well-being of the people. Therefore, major psychosocial interventions are required to restore the damages caused by the war. The promotion of human rights and justice are the key way to reinstate the social equilibrium. The victims of war trauma need appropriate treatment psychosocial support and culturally sensitive rehabilitation. Apart from these measures infrastructure reconstruction and reconciliation should be focused in the post-war Sri Lankan society.

References

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Baro, M. (1994) . Writings for a liberation psychology, Harvard University Press.

Bashir, M.U., Tahir, M.Z., Bari, E., Mumtaz, S. (2013).Craniocerebral injuries in war against terrorism — a contemporary series from Pakistan. Chin J Traumatol.  16(3):149-57.

Batista, P. & Wiese, E. ( 2010) .   Culture and Migration: Psychological Trauma in Children and Adolescents.  Traumatology   16: 142152

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http://www.srilankaguardian.org/2011/02/combat-related-ptsd-among-sri-lankan.html

Human Rights Watch. (2004) .  Sri Lanka: Tamil Tigers Forcibly Recruit Child Soldiers.  November 12, 2004 Retrieved from

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Jayatunge, R. (2004) . PTSD Sri Lankan Experience , ANL Publishers Colombo.

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Londoño,A,.   Romero,P.,    Casas , G.(2012).The association between armed conflict, violence and mental health: a cross sectional study comparing two populations in Cundinamarca department, Colombia.Confl Health.6: 12.

Minas,H (2012). The Centre for International Mental Health Approach to Mental Health System Development. Harv Rev Psychiatry.20(1): 37–46.

Nandi,C. (2013).War trauma and PTSD among German war survivors : A comparison of former soldiers and women of World War.

Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23695004

Perry, B.D. (2003) Effects of Traumatic Events on Children. Retrieved from http://www.mentalhealthconnection.org/pdfs/perry-handout-effects-of-trauma.pdf

Robertson, M., Rushton, P.J., Bartrum, D., Ray ,R. (2004).Group-based interpersonal psychotherapy for posttraumatic stress disorder: theoretical and clinical aspects.

Somasundaram , D. (2007) .  Collective trauma in northern Sri Lanka: a qualitative psychosocial-ecological study.   International Journal of Mental Health Systems 2007, 1:5

Sørensen, B. (1998).  Women and Post-Conflict Reconstruction.  Retrieved from http://www.unrisd.org/unrisd/website/document.nsf/0/631060b93ec1119ec1256d120043e600/$FILE/opw3.pdf

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Sriyananda, S. (2012 September 24). Nearly 400 soldiers commit suicide in peacetime. The Island Newspaper. Retrieved on February 14, 2013, from  http://www.island.lk/index.php?page_cat=article-details&page=article-details&code_title=62302

Tribe, R., & Silva, P. D. (1999). Psychological intervention with displaced widows in Sri Lanka. International Review of Psychiatry, 11, 184-190.

Watters,  E. (2010) . Crazy Like Us: The Globalization of the American Psyche.  Free Press.

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